Marjy Zaher, Slutzky-Goldberg Iris
Department of Endodontics, Galilee College of Dental Sciences, Nahariya, Israel.
Department of Endodontics, Galilee College of Dental Sciences, Nahariya; Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel.
Int J Clin Pediatr Dent. 2024 Oct;17(10):1168-1171. doi: 10.5005/jp-journals-10005-2962.
Regenerative endodontic treatment (RET) has been suggested for the treatment of traumatized necrotic immature teeth. There are only a few reports of using RET to treat a horizontal root fracture. The aim of this paper is to describe successful regenerative retreatment in a tooth with a horizontal root fracture and dens invaginatus. A 9-year-old boy presented with a horizontal root fracture in a central incisor. Pulp necrosis and inflammatory root resorption were observed. The tooth was treated by RET, including calcium hydroxide dressing between visits. After bleeding was allowed into the canal space, a collagen plug was placed as a barrier, and covered by a bioceramic material. At the completion of treatment, the resolution of the radiolucent lesion was evident. During follow-up, the tooth exhibited recurrent pathology at the fracture line. The patient was scheduled for retreatment of the tooth. Repeated RET included additional ultrasonic irrigation and calcium hydroxide dressing. One year after the completion of retreatment, the periradicular lesion resolved with continued maturogenesis of the apical fragment and approximation of the coronal and apical fragments that were attached by a calcified tissue and surrounded by the continuous periodontal ligament.
This rare case report of retreatment after failed RET is notable for the repeated use of a regenerative procedure subsequent to a recurrent traumatic injury to the tooth. The repeated regenerative endodontic procedure (REP) resulted in the resolution of the periapical lesion and the reunion of the apical and coronal fragments.
Failure of an already successful RET due to a recurrent traumatic injury may be successfully treated by repeating the RET, particularly when the alternative treatment option is extraction.
Marjy Z, Slutzky-Goldberg I. Retreatment of a Failed Regenerative Endodontic Treatment in an Immature Tooth with a Horizontal Root Fracture: A Case Report. Int J Clin Pediatr Dent 2024;17(10):1168-1171.
再生性牙髓治疗（RET）已被建议用于治疗外伤致坏死的未成熟恒牙。仅有少数关于使用RET治疗水平根折的报道。本文旨在描述一例水平根折合并牙内陷患牙成功进行再生性再治疗的病例。一名9岁男孩，其一颗中切牙发生水平根折。观察到牙髓坏死及炎性牙根吸收。该患牙采用RET治疗，治疗期间使用氢氧化钙封药。在根管内有渗血后，放置胶原塞作为屏障，并覆盖生物陶瓷材料。治疗结束时，透射区明显消退。随访期间，患牙在骨折线处出现复发性病变。该患者被安排对患牙进行再治疗。再次进行的RET包括额外的超声冲洗和氢氧化钙封药。再治疗完成一年后，根尖周病变消退，根尖断端持续成熟，冠方与根尖断端通过钙化组织连接并被连续的牙周膜包绕。
这例罕见的RET失败后再治疗病例值得关注，因为患牙反复遭受创伤性损伤后重复进行了再生治疗。重复的再生性牙髓治疗（REP）使根尖周病变消退，根尖与冠方断端愈合。
因反复创伤性损伤导致原本成功的RET失败时，重复进行RET可能成功治疗，尤其是在替代治疗方案为拔牙时。
Marjy Z, Slutzky-Goldberg I. 水平根折未成熟恒牙再生性牙髓治疗失败后的再治疗：一例报告。《国际临床儿科牙科学杂志》2024；17(10):1168 - 1171。
